2012年至2022年上海市某三级甲等医院人类免疫缺陷病毒筛查阳性率变化趋势及筛查试剂性能评价  

Trend of positive screening rate for human immunodeficiency virus and evaluation of screening reagent performance in a grade A tertiary hospital in Shanghai City from 2012 to 2022

作　　者：李俊婷 张鹏 刘毅 窦敏[1] 陈瑾[1] 陈惠[1] Li Junting;Zhang Peng;Liu Yi;Dou Min;Chen Jin;Chen Hui(Department of Clinical Laboratory,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院检验科,上海200092

出　　处：《中华传染病杂志》2024年第6期363-367,共5页Chinese Journal of Infectious Diseases

摘　　要：目的分析人类免疫缺陷病毒(HIV)确证阳性率、确证阳性感染者的流行病学特征、HIV筛查试剂的性能,为制订有针对性的艾滋病防治措施提供科学依据。方法回顾性分析上海交通大学医学院附属新华医院2012年1月至2022年12月HIV初筛疑似阳性并经上海市杨浦区疾病预防控制中心HIV确证实验室确认的HIV感染者的临床资料,分析HIV确证阳性感染者的临床流行病学特征。分析HIV初筛试剂的筛查结果与确证结果之间的一致性。统计学分析采用趋势χ2检验,采用受试者操作特征曲线(ROC曲线)分析HIV初筛化学发光值的诊断能力。结果共筛查702949例门诊/住院患者及健康体格检查者,初筛疑似阳性468例(0.067%),确证HIV阳性感染者202例,阳性率为0.0287%;2012年至2022年HIV确证阳性率呈下降趋势(χ_(趋势)^(2)=17.28,P<0.001)。HIV感染确证阳性患者中,男180例(89.11%),女22例(10.89%)。HIV确证阳性感染者户籍分布以上海市为主,为114例(56.44%),其次为安徽省18例(8.91%)和江苏省16例(7.92%)。HIV合并梅毒螺旋体感染病例70例(34.65%)。HIV初筛试验(化学发光微粒子免疫检测法)的化学发光值的ROC曲线下面积为0.973[95%可信区间(CI)0.961~0.985,P<0.001],最佳临界值对应的约登指数为0.834,对应的化学发光值为59.48吸光度值/临界值(S/CO),灵敏度为89.10%,特异度为94.30%。HIV抗体胶体金法的准确率为85.95%(318/370),灵敏度为98.30%(173/176),特异度为97.32%(145/149)。结论HIV检测阳性率呈下降趋势,HIV感染人群以男性为主,户籍分布以上海市为主。HIV抗体胶体金法的特异性较高。Objective To analyze the confirmation rate of human immunodeficiency virus(HIV),the clinical epidemiological characteristics of confirmed HIV-infected individuals,and the performance of HIV screening reagents,so that to provide scientific basis for local development of acquired immunodeficiency syndrome prevention and control measures.Methods Clinical data of HIV infected individuals who were suspected to be positive during the initial screening of HIV in Xinhua Hospital,Shanghai Jiao Tong University School of Medicine and confirmed by the HIV confirmed laboratory of Center for Disease Control and Prevention in Yangpu District Center,Shanghai City from January 2012 to December 2022 were retrospectively analyzed,and the analysis of the clinical epidemiological characteristics of HIV confirmed positive infections was performed.The consistency was analyzed between the screening results and confirmation results of HIV initial screening reagents.Trend chi-square test was used for statistical analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic ability of HIV initial screening chemiluminescence values.Results A total of 702949 outpatient/inpatient patients and healthy individuals were screened,with 468 suspected positive cases(0.067%)initially screened and 202 confirmed HIV positive cases,with a positive rate of 0.0287%.The HIV confirmed positive rate showed a downward trend from 2012 to 2022(χ_(trend)^(2)=17.28,P<0.001).Among confirmed HIV positive patients,there were 180 males(89.11%)and 22 females(10.89%).Among the confirmed HIV positive cases,Shanghai City residents accounted for 56.44%(114 cases),while Anhui Province residents accounted for 8.91%(18 cases)and Jiangsu Province residents accounted for 7.92%(16 cases).There were 70 cases(34.65%)of HIV co-infection with Treponema pallidum.The area under the ROC curve of the chemiluminescence value of the HIV initial screening test(chemiluminescence particle immunoassay)was 0.973(95%confidence interval(CI)0.961 to 0.985,P<0.001).The

关 键 词：人类免疫缺陷病毒 上海 感染率 流行特点 检测 

分 类 号：R512.91[医药卫生—内科学]